Various cervical thoracic orthoses have been developed for treating cervico-thoracic injuries of the upper thoracic spine and lower cervical spine. Some of these are collars which function to partially immobilize the head and neck of the patient and relieve spasm or strain by transferring load or force from the head of a patient to the shoulders or adjacent areas of the patient. Other devices designed for complete or near complete immobilization of the head and neck of the patient have also been developed.
A feature, preferably included in cervical thoracic orthoses to overcome limited adaptability or to accommodate the body of the patient and the particular ailment prompting the need for wearing an orthosis, is the facility for adjusting the relative positions of various components of the cervical thoracic orthosis. Currently available orthoses generally lack such features.
Various types of cervical thoracic orthoses have been developed in treating conditions of the cervical spine, cervico-thoracic junction (i.e. the upper thoracic spine and lower cervical spine) or occipital-cervical junction (i.e. occiput to upper cervical spine). Some of these are collars, which are used merely where support for the head and neck is needed. The primary objective for the use of such a collar is to partially immobilize the head and neck, to maintain a desired spinal alignment, to provide support for the head, and to relieve any spasm or strain to which the neck muscles may be subjected by transmitting load or force from the head to the shoulders or adjacent area. Other collars are intended for use where near complete immobilization of the head and neck are necessary such as when a patient is attended to by emergency medical personnel prior to admission to a hospital. There are a multitude of cervical collars intended to perform one or more of the above-mentioned functions.
U.S. Pat. No. 5,776,088—Sereboff describes an adjustable, flexible cervical collar designed for universal use by providing vertically adjustable movable sections that support the chin and the back of the head, which can also be displaced around the circumference of the collar.
Other collars intended for partial or total immobilization are shown in U.S. Pat. No. 4,502,471—Owens and U.S. Pat. No. 4,582,051—Greene et al. Both these collars attempt to provide stability by providing a front and rear brace that connects a collar to a lower section that either rests on the patients shoulders or is a belt surrounding the thorax. A more elaborate version of such a brace is disclosed by U.S. Pat. No. 5,531,669—Varnau, which has adjustable pads to support the chin and the occiput, that are in turn supported by flexible and vertically adjustable members that are attached to a vest that is fitted over the shoulders and which has a strap that surrounds the thorax.
Other prior art devices include cervical orthosis or a brace that restrains the head from movement by a band attached to the forehead of the patient, which is then restrained by connecting the band to the shoulders or upper thorax. Such a device is shown in U.S. Pat. No. 5,624,387—McGuiness, which uses a set of adjustable rods and bars to effect stabilization. Another device in this category is shown in U.S. Pat. No. 5,575,763—Nagata et al., which discloses restraint and stabilization using an integrally molded device that can only be fitted within narrow ranges of adjustment.
The highly constraining systems described above can cause unwanted compensatory movement of the spine as a result of mechanically overconstraining the brace. Device-induced compensatory motion can create additional orthopedic problems.
Thus there remains a long-felt, yet unmet, need for a cervico-thoracic orthosis that is comfortable to the wearer, allows better protection of the cervical junctions and can be easily adapted to a wide variety of patient phenotypes that exist, without the need for extensive customization.